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Orientation Program for Massachusetts Boards of Health

Orientation Program for Massachusetts Boards of Health. History, Functions, Essential Services and Duties of Local Board of Health Members. Marcia Benes Executive Director MAHB November 2013. Orientation Objectives. Public Health Defined Historic Highlights

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Orientation Program for Massachusetts Boards of Health

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  1. Orientation Program for Massachusetts Boards of Health History, Functions, Essential Services and Duties of Local Board of Health Members Marcia Benes Executive Director MAHB November 2013

  2. Orientation Objectives • Public Health Defined • Historic Highlights • Description of Public Health System • Some important PH Terms • BOH Responsibilities • Assessment Tools & Resources 2

  3. Volunteer BOH members come from many walks of life and perform a valuable role of citizen oversight & community representation. • Nurses • Pharmacistsand many others • Retired Judges • Doctors, Veterinarians & Dentists • Engineers & Lawyers

  4. What is Public Health? Public Health is the science and art of: (1) Preventing Disease (2) Prolonging life, and (3) Promoting health and efficiency through organized community effort for the following...

  5. lThe sanitation of the environment, lthe control of communicable infections, lthe education of the individual in personal hygiene, lthe organization of medical and nursing services for the early diagnosis and preventative treatments of disease, and lthe development of the social machinery to ensure everyone a standard of living adequate for the maintenance of health so organizing these benefits as to enable every citizen to realize his birthright of health and longevity - C. Winslow 1920

  6. The World Health Organization Defines Public Health as: “A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”

  7. Public Health in History • Those who cannot remember the past are condemned to repeat it. - George Santayana • With Climate Change and the resurgence of ancient diseases like Tb and new threats like MRSA, we cannot afford to forget the lessons of history.

  8. Public Health in England • 1796 Edward Jenner discovers small pox vaccination • l1837 - English Law first recognizes public health with the Establishment of a National Vaccination Board • l1847 - Edwin Chadwick publishes “Report on an Inquiry into Sanitary Conditions of the Labouring Population of Great Britain” • Dr John Snow removes pump handle and stops cholera outbreak • l1848 - England establishes a General Board of Health

  9. Public Health in America l1647 : Massachusetts Bay Colony passed a regulation to prevent pollution of Boston Harbor l1692-1708 : Boston, Salem and Charleston passed acts dealing with nuisances and trades offensive and dangerous to the public health l1799: Boston forms a Board of Health with patriot Paul Revere serving as Chairman

  10. l1850: Lemuel Shattuck completes “Report of the Sanitary Commission of Massachusetts”. It is virtually ignored. l1869: Massachusetts finally responds to the Shattuck Report, creating the first state Board of Health. l1979: DEQE (DEP) is separated from DPH creating a dichotomy between public and environmental health at the state level. President Nixon creates EPA from HHS

  11. September 11, 2001 World Trade Center Bombing - Health Department Role in Emergency Response and Post Event Threat Assessment • October 2001 – Anthrax attack challenges state and local health departments even in Massachusetts, where no anthrax is found • Summer 2003 – SARS outbreak – Isolation and Quarantine re-emerge from the past as an important tool for controlling disease. 11

  12. December, 2003 - Four children die of influenza in Colorado. Evening news reports shortage of flu vaccine. Vaccine manufacturers say it will take many months to make more. CDC reports it is not a perfect match to the flu. • Flu Pandemic is the natural outbreak most feared by many PH experts. • 2010 – Emergency funds are distributed to local boards of health in anticipation of a pandemic H1N1 influenza outbreak • EEE and West Nile Virus are seasonal threats to Massachusetts - Dengue fever now endemic in parts of the US. 12

  13. The Board of Health is part of theLocal Public Health System Other partners include community groups, HMO’s, local hospitals and Visiting Nurses. 13

  14. Public Health Systems • Prevent epidemics and the spread of disease • Protect against environmental hazards • Prevent injuries • Promotes and encourages healthy behaviors • Emergency ResponseAssures quality & accessibility of health services

  15. CDC 10 Essential Public Health Services In 1994, local, state, and national public health leaders developed a consensus list of the 10 essential public health services needed to carry out these core functions of public health

  16. 3 Primary Functions of Board of Health/ Health Department l Assessment l Policy development (Regulations) l Assurance

  17. The 6 Functions of Public Health Governance Partner Engagement Continuous Improvement Oversight • Policy Development • Resource Stewardship • Legal Authority 17

  18. Massachusetts Virtual Epidemiologic Network (MAVEN) • Each local board of health shall utilize the secure electronic disease surveillance and case management system designated and maintained by the Department. • DPH and LPH share disease reports, lab results, clinical data (TB, vaccine-preventable, foodborne, zoonotic diseases) • Training in MAVEN on-going

  19. Compare Health Status Indicators to Assess Community Health • Sociodemographic • Perinatal and Child Health • Infectious Disease • Injury • Chronic Disease • Substance Abuse • Preventable Hospital Discharge Data 19

  20. Massachusetts Community Health Information Profiles (MassCHIP) • Integrates 39 data bases online, including MDPH and other state agencies • Critical resource for health assessments, planning, research, grant applications 20

  21. Community Health Information Profile (Mass CHIP) Instant Reports Custom Reports Charts & Graphs Calculate basic statistics and measures on data you access, including: Percentages and proportions Crude rates Age-adjusted rates Age-specific rates Standardized ratios Modified counts, proportions, and rates for Mortality (ICD-10 based) Data Set  21

  22. Evidence-Based Interventions – The Community Guide Current Topic Areas • Adolescent Health • Alcohol • Asthma • Birth Defects • Cancer • Diabetes • HIV/AIDS, STIs & Pregnancy • Mental Health • Motor Vehicle • Nutrition • Obesity • Oral Health • Physical Activity • Social Environment • Tobacco • Vaccines • Violence • Worksite • http://nalboh.org/Community_Guide.htm 22

  23. Analyzing Staff Resources l Consider both the number of full time equivalents in each job position, and the allocation of time to these individuals. l Review Job Descriptions: The BOH should specify, in writing, the expected duties of staff.

  24. Risk Communication Designate a Public Information Officer (either a BOH member or agent) The Public Information Officer should be trained in the art of Risk Communication - informed and practiced in proven risk communication techniques. 24

  25. Challenge: To communicate the complexities and uncertainties of risk so it can be accepted, understood and managed. • Know your public and speak to their concerns. • 3 goals of risk communication:1. Increase knowledge and understanding • 2. Enhance trust and credibility3. Resolve conflict MESSAGE - What to Say MESSENGER – Who to say it MEDIA – How should it be presented 25

  26. If you are a new board member: Make sure that you are provided the information you will need to assume the responsibilities of your office. 26

  27. New Board Member Orientation Information Contact InformationDescription of local health servicesDescription of on-going or recent legal issuesBudget for previous & present yearMinutes for past 2 yearsDepartment finances, fees and other income sources 27

  28. Local health regulations and pertinent bylaws Job descriptions for all professional staff, Evaluation plan for Health Director or Agent & Public Health Nurse Board Evaluation Plan Medical Reserve Corp structure and Emergency Preparedness Plans 28

  29. Challenges • Economic downturn • Graying of PH workforce combined with inadequate educational and mentoring opportunities create an unsteady career ladder in local public health • Climate Change impacts on public health • Separation of inspectional services from local boards of health via town charter changes • Positive Trend -National accreditation and recognition of Local Boards of health 29

  30. Resources www.mahb.org- learn your board’s login and password to obtain access to member services including Guidebook for Massachusetts Boards of Health, legal memos and other resources. Add to the growing knowledge base by completing your BOH profile and the BOH salary and staffing survey Cheryl Sbarra – MAHB Senior Staff Attorney 30

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